The Upside of Suffering

A few years ago, at mile 20 of my second marathon, I promised myself I would never again run a 26.2 mile race. I had trained impeccably, ran my first mile a little slower than goal pace, as everyone advises, and was primed to shave seven minutes off my previous time and traverse the five boroughs of New York City in a tick under three hours. For a confluence of reasons (our three-week-old baby daughter was a source of much joy but little rest; I ran the first 13 miles way too fast; it was a warm day) things turned very sour late in the race. I grew exhausted. I slowed to a walk. My calves seized up. Dizzyness. Nausea. The works.

True to my pledge, I haven't run a marathon since. I've been happy to race shorter distances. But now I'm thinking about breaking my promise to my future self and giving the 26.2 another go. As vividly as I remember the vividness of my suffering late in that race, I don't recall the suffering itself. My body does not feel the pain or experience the vertigo I suffered on the subway ride home afterward. In my first marathon, too, I had “hit the wall,” a disconcerting feeling of existential frailty brought on when glycogen stores in the liver run dry, but not nearly as hard as it smacked me a year later. I had managed to end strong the first time. I decided to come back for more.

How We Relate to Pain

Daniel Kahneman's 2011 book, "Thinking, Fast and Slow," is a justly celebrated survey of decades of research into how people make decisions. It is wide-ranging and fascinating. It exposes sobering truths about just how error-prone and full of bias we are. But in Chapter 35, Kahneman succumbs to an error of his own when he indicts the human capacity to process and conceptualize pain. Contrary to Kahneman's claims, if it were not for our relentless drive to come back for more punishment, we would not undertake challenging projects, we would not have very meaningful lives and the future of humanity may even be in doubt.

Kahneman's pointed comments about pain-related decision-making stand out as some of the most emphatic in a book that closes on an admirable note of restraint. Contrary to many interpretations, Kahneman does not present a global indictment of the rationality of human beings:

I often cringe when my work with Amos [Tversky] is credited with demonstrating that human choices are irrational, when in fact our research only showed that Humans are not well described by the rational-agent model....Although Humans are not irrational, they often need help to make more accurate judgments and better decisions, and in some cases policies and institutions can provide that help.

But Kahneman abandons this modesty in his discussion of what he regards as a deeply unfortunate disjunction between the “experiencing self” and the “remembering self.” Here Kahneman minces no words. This chasm, he worries, brings us needless suffering and drags down the pleasure we experience in our lives.

Back to marathoners and other willing sufferers in a moment. First, let us understand what Kahneman means by this alleged gap between the “experiencing” and “remembering” selves. Thinking back on painful experiences leads us down paths of misdirection, Kahneman laments: we are hopelessly misled when we try to recall past experiences of pain.

Kahneman first identified this “cognitive trap” in an experiment he conducted in the early 1990s where patients undergoing colonoscopies without anesthesia were asked, minute-by-minute, to rate their pain on a scale of 0-10 and then, after the procedure was complete, quizzed on the “total amount of pain” they experienced. (No one seems to have wondered how much more unpleasant the experience became with the addition of a clipboard-wielding researcher asking questions every 60 seconds.) The results were intriguing. Although asked to report the “total” amount of pain (which, objectively, would be the self-reported pain levels averaged over the length of the procedure), the subjects' responses deviated sharply from the answers they gave just minutes earlier. The participants ignored the clock and reported a “total pain” level matching this formula: (worst pain experienced + pain level at the end of the procedure) ÷ 2. Here is how Kahneman summarizes the rules the subjects were inadvertently following:

Peak-end rule: The global retrospective rating was well predicted by the average of the level of pain reported at the worst moment of the experience and at its end.

Duration neglect: The duration of the procedure had no effect whatsoever on the ratings of total pain.

One patient whose colonoscopy lasted 24 minutes rated his total pain as 4.5 while another patient who was in and out in a brisk 8 minutes rated his at 7.5. Why? Both patients had a peak pain level of 8, so that can't account for the gulf. The key difference is how things ended for the patients: the first subject's experience was pretty awful at the end of the procedure (a pain level of 7) while the patient who spent almost half an hour on the table experienced a very mild pain level of 1 as things came to a close. The “tyranny of the remembering self,” Kahneman tells us, is responsible for the “mistakes” these patients made about their total pain. We remember the worst moment and the end, not all the moments in between. A searing pain coming as the doctor finishes a short procedure taints the experience as awful, while a drawn-out colonoscopy with terrible pain in the middle but little discomfort at the end is no biggie: all's well that ends well.

In another illustration of this “cognitive illusion,” Kahneman subjected subjects to two unpleasant stints where they were asked to submerge their hands in painfully cold water. One bout lasted 60 seconds, the other 90 seconds (half of the subjects had the longer experience first, the other half had the shorter one first). After drying off, subjects were then asked which form of icy torture they preferred to experience again. They chose to relive the shorter torture, right? No. The subjects opted for the extra 30 seconds of pain. Here's why: In the 90-second cold-water bath, the final half-minute offered partial relief from the cold, with warmer water flowing into the tank and raising the temperature by 1 degree celsius. Consistent with the principle that duration of suffering doesn't matter to us but the end of the experience does, the subjects remembered the longer ice bath as the milder one.

Kahneman's Complaint

This result gives Kahneman fits. If you prefer more pain to less, he reasons, something is wrong with you. The shorter colonoscopy is better for us, even though it ended more painfully, and the 60-second ice bath is objectively preferable to the 90-second stint. “The subjects who preferred the long episode were not masochists and did not deliberately choose to expose themselves to the worse experience,” Kahneman exclaims, “they simply made a mistake.”

But did they? Is “something wrong” with these decisions, as Kahneman declares? Is this “inconsistency built into our minds,” as he puts it, really such a problem? For Jeremy Bentham, the father of utilitarianism — who holds that the value of life is a calculus of moments of pleasure balanced against moments of pain — the answer is yes. Preferring more pain to less is irrational. But Kahneman adopts this perspective reflexively, with no justification and no consideration of the philosophical and religious debates that swirl around the topic.

If anything is clear from these experiments, it is this: human beings are not Benthamites when it comes to assessing the value of our experiences. We don't mind suffering all that much if the pain is followed by less suffering. Even better if something lovely follows from the suffering.

Yet marathon entries surge every year. Why? Here is one account of the payoff:

The marathon distance is exquisitely set to take us beyond our comfort zone, into a realm in which we confront the limitations of our bodies and our minds. We complete the marathon distance only by patient preparation and mental discipline. There are no short cuts, no easy ways out. The marathon takes us up to, and beyond, the limit of human endurance, into an unknown zone where we confront our true selves, and discover our inner strengths and limits.

Fine. But isn't signing up for such a long race still a sign of hopelessly poor decision-making? Should we counsel runners to avoid marathons because training for and racing this distance is an extremely bad bet for the maximization of pleasure? Should legislators consider protecting their constituents' pain-pleasure profiles by banning the events?

Leaving aside the merits of institutional efforts to force an orientation to our “experiencing self,” imagine what would happen if our psyches were capable of heeding Kahneman's advice. Would our lives be better off? Kahneman seems convinced the answer is yes. In his 2010 TED talk on this topic, he said that “what happens during these moments of experience is our life. It’s the finite resource that we are spending while we are on this earth.” To ignore the quality of our momentary experiences, Kahneman warns, is to give our lives over to untold suffering.

But is a life really best measured as a sum of moments? And isn't there something to the Hindu belief that since life is suffering, the relentless attempt to escape moments of pain is fruitless and counterproductive?

If marathoners popped a Kahneman “experiencing self” pill to counter the tyranny of the "remembering self," few would repeat their performances, despite the ineffable high that comes from the experience — a feeling of accomplishment at what the human body can do under incredible strain. The objective pain level is too high to justify such flighty fancies of pride. When weighing whether to run another marathon, a Kahnemanian runner would relive with utter clarity the pain she encountered training and/or running the race the last time and skip the 26.2 miles for a less audacious training program. I certainly would not be thinking about going out for a third time after my NYC disaster. It is hard to imagine how anyone reoriented in the way Kahneman prescribes would subject himself to an Ironman triathlon or a 135-mile Badwater ultramarathon in 130-degree desert heat, with the bleeding nipples, crippling blisters and dehydration-induced hallucinations these can bring.

The same principle holds beyond the athletic realm wherever you find willing sufferers engaged in productive or otherwise choice-worthy endeavors: in settings as diverse as graduate school, Catholic communities during Lent, S&M dens and — most notably — the maternity ward. The pain of childbirth has been described by many as the worst pain anyone can experience. Even with epidurals and other powerful pain-relief techniques, pregnancy and childbirth can be among the most uncomfortable experiences human beings willingly and consistently choose to endure. (To say nothing of the sleep deprivation and loss of independence that follows when the baby comes home.) If women tuned their decision-making to the “experiencing self,” as Kahneman prefers, few would willingly have a second baby. Birthrates would decline. The survival of the human race, among other things, seems to depend on an supremely helpful cognitive bias.

So yes, the remembering self ignores duration and thinks in terms of peaks and ends rather than sum totals. But life gets its meaning from episodes with beginnings and endings — relationships, projects, challenges, careers — not from integrals of discrete minute-by-minute happiness packets. Life is lived minute by minute, but conglomerations of minutes are not the basis of judging a life. Who lies in bed at night, reviewing the day, and tallies a sum total of pleasure versus pain experienced as the metric for how the day went? Not even the most committed hedonic utilitarian would measure the value of his life this way. We might remember a high and a low, but we don't care about “area under the curve,” and we shouldn't. The sum total of pleasure and pain might be interesting to track, but this measurement does not give us much of a clue about how well our lives are going.

Not all suffering is to be welcomed or applauded, of course. There is no upside to purposeless, unrelenting, severe pain. But, fortunately, this is not the type of suffering that attracts us. We are drawn to running marathons, to volunteering for organ transplants to save others' lives, to giving birth to children, despite the pain that our "experiencing self" will endure in the process. You don't have to be a masochist or an ascetic to conclude from innumerable examples that working through difficult, even profoundly painful experiences, can add to, not detract from, the meaning and satisfaction of our lives. In Nietzsche’s words: “Did you ever say yes to a pleasure? Oh my friends, then you also said yes to all pain. All things are linked, entwined, in love with one another.”

A glass of juice has as much sugar, ounce for ounce, as a full-calorie soda. And those vitamins do almost nothing.

Quick: think back to childhood (if you've reached the scary clown you've gone too far). What did your parents or guardians give you to keep you quiet? If you're anything like most parents, it was juice. But here's the thing: juice is bad for you.